Exploring the Effectiveness of a Mixed-Diagnosis Group Cognitive Behavioral Therapy Intervention Across Diverse Populations

Depression and anxiety are the most common mental health disorders seen in clinical practice and they are highly comorbid. Cognitive behavioral therapy (CBT) has been demonstrated as an effective treatment for both depression and anxiety but is often not available to all individuals who could benefit from it. This paper investigates the effectiveness of a mixed-diagnosis group CBT intervention that incorporates mindfulness meditation for individuals presenting with depression and/or anxiety: CBT Basics II. This intervention was evaluated across two distinct mental health programs to determine both if it can demonstrate positive results and if it is feasible to implement in these types of programs. Sample 1 (n = 42 completers) consisted of higher-functioning individuals in a general mental health program. Sample 2 (n = 53 completers) consisted of individuals with more chronic and severe mental health diagnoses. Overall, intent-to-treat analyses revealed improvements in psychiatric symptoms, and increases in CBT knowledge and mindfulness skill across both programs. This indicates that CBT Basics II is effective across diverse mental health populations and shows promise for improving access to CBT.     

Reduced looming sensitivity in primary school children with Developmental Co-ordination Disorder

Almost all locomotor animals are sensitive to optical expansion (visual looming) and for most animals this sensitivity is evident very early in their development. In humans there is evidence that responses to looming stimuli begin in the first 6 weeks of life, but here we demonstrate that as children become independent their perceptual acuity needs to be 50 to 100 times better than has been demonstrated in infants in order to be skilful at collision avoidance at a roadside. We have recently established that sensitivity to the detection of visual looming in 6- to 11-year-old children is significantly below that of adults (Wann, Poulter & Purcell, 2011). Here, using comparable methods, we explore looming detection sensitivity in children with Developmental Co-ordination Disorder (DCD), who show broad patterns of impairment in visuo-motor control. We presented visual simulations of approaching vehicles, scaled to represent different approach rates, to children with DCD aged between 6 and 11 years (n = 11) and typically developing age and gender matched controls (n = 11). Looming detection thresholds were measured under foveal and perifoveal viewing conditions, for isotropic expansion and isotropic expansion with simulated viewpoint motion. Our results show that there are situations in which children with DCD may fail to detect vehicles approaching at speeds in excess of 22 km/h, suggesting a developmental immaturity in looming sensitivity. This provides one of the first clear demonstrations of low-level motion processing deficits in children with DCD. The decrement observed may give rise to potential errors in the road crossing behaviour of these children, whereby approaching vehicles could be perceived as stationary. These findings further contribute towards understanding the adverse statistic that children under 9 years of age are four times more likely than adults to be involved in a road accident as a pedestrian.     

Sense making and benefit finding in couples who have a child with Asperger syndrome: an application of the Actor-Partner Interdependence Model

Parents of children with Asperger syndrome face many challenges that may lead them to search for meaning by developing explanations for (sense making) and finding benefits (benefit finding) in having a child with special needs. Although family theorists have proposed that finding meaning occurs interpersonally, there is a dearth of empirical research that has examined finding meaning at the couple level. This study examined sense making and benefit finding in 84 couples who have a child with Asperger syndrome by using the Actor-Partner Interdependence Model (Kenny et al., 2006) to examine actor effects (i.e. the extent to which an individual's score on the predictor variable impacts his or her own level of adjustment) and partner effects (i.e. the extent to which an individual's score on the predictor variable has an impact on his or her partner's level of adjustment) of sense making and benefit finding on parental adjustment. Results demonstrated that parents' benefit finding related to greater anxiety and parents' sense making related to not only their own adjustment but also their partner's adjustment. Results highlight the importance of adopting an interpersonal perspective on finding meaning and adjustment. Limitations, future research and clinical implications are also discussed.     

A qualitative investigation into the online counselling relationship: To meet or not to meet,that is the question

Background and aim: Online counselling, as a psychotherapeutic approach, provokes debate amongst practitioners and researchers concerning its efficacy and validity. This reflexive study extends existing research into the nature of the online counselling relationship when it is conducted asynchronously (by email) and explores the possibility this approach may facilitate both online and face‐to‐face therapeutic engagement. Method: Semi‐structured interviews were conducted electronically with ten former email counselling clients of a university counselling service and six counsellors delivering email counselling in other higher education settings, to explore, in depth, their experiences of the online therapeutic relationship and its impact on the counselling process and outcomes. These were analysed using Interpretative Phenomenological Analysis (IPA). Findings: Four areas of focus emerged relating to: (1) the importance of the structure and processes involved; (2) their impact on thinking and feeling; (3) their impact on self and relationships (within and outside counselling), and (4) changes that followed email counselling. Having ‘time to think’ within the asynchronous exchanges, the anonymity and disinhibition afforded by the online medium, the creation of transitional space and the rich use of metaphor, visualisation and imagery all contributed to a sense of empowerment and relational depth for individuals who might have otherwise avoided seeking help. This led to positive change in many cases and for some, facilitated subsequent face‐to‐face counselling. Implications: The findings support the provision of counselling and therapy online and particularly its integration within existing face‐to‐face services.     

CUE: The continuous unified electronic diary method

In the present article, we introduce the continuous unified electronic (CUE) diary method, a longitudinal, event-based, electronic parent report method that allows real-time recording of infant and child behavior in natural contexts. Thirty-nine expectant mothers were trained to identify and record target behaviors into programmed handheld computers. From birth to 18?months, maternal reporters recorded the initial, second, and third occurrences of seven target motor behaviors: palmar grasp, rolls from side to back, reaching when sitting, pincer grip, crawling, walking, and climbing stairs. Compliance was assessed as two valid entries per behavior: 97?% of maternal reporters met compliance criteria. Reliability was assessed by comparing diary entries with researcher assessments for three of the motor behaviors: palmar grasp, pincer grip and walking. A total of 81?% of maternal reporters met reliability criteria. For those three target behaviors, age of emergence was compared across data from the CUE diary method and researcher assessments. The CUE diary method was found to detect behaviors earlier and with greater sensitivity to individual differences. The CUE diary method is shown to be a reliable methodological tool for studying processes of change in human development.     

Family of Origin Coaching for Clinicians in a Child and Adolescent Mental Health Service

The role of the therapist as a person rather than only as a technician has become increasingly important in family therapy since the post-modern turn. Despite this there is a paucity of research exploring supervision models that focus on self-reflection, as opposed to clinical competence. This study documents the experience of a Family of Origin Coaching group, conducted with six clinicians and one supervisor working in a child and adolescent mental health service. A participatory action framework was used, with data analysed using grounded theory. A variety of benefits were reported, including personal development, an enhanced empathy towards clients and an ability to better cope with stressful team dynamics. Family of Origin coaching has the potential to yield benefits for clinicians as a compliment to traditional supervision. Issues of confidentiality and safety need to be addressed carefully, especially during times of organisational change or stress.     

Psychological Distance and the Discrepancy Between Recommendations and Actions

Action hypocrisy is the tendency to recommend behavior for others that one would personally be unwilling to undertake. Six studies examine the relationship between action hypocrisy and psychological distance. Studies 1a and 1b and 2 demonstrate action hypocrisy in three populations and in 2 different contexts. Studies 3 to 5 support a psychological distance explanation for action hypocrisy: people are more likely to choose action for themselves in the future versus the present (Study 3), for someone at a distant location versus a nearby location (Study 4), and for someone who appears to be distant versus close in a photograph (Study 5).     

Mental state decoding in past major depression: Effect of sad versus happy mood induction

Individuals with mild depression show an enhanced ability to read or “decode” others' mental states. The goal of the present study was to investigate whether this pattern of performance is related specifically to the pathology of depression or whether it is simply a feature of the transient dysphoric state. Forty-one undergraduates with a previous episode of major depression and 52 undergraduates with no depression history participated in a mental state decoding task following a sad versus happy mood induction. Previously depressed participants were significantly more accurate in their mental state judgements than were the never-depressed participants, suggesting that enhanced mental state decoding may be a specific feature of depression in remission. Furthermore, previously depressed participants whose positive mood increased in response to the happy mood induction showed a poorer level of performance on the task, similar to that observed in the never-depressed group. Thus, a happy mood may have induced a somewhat less accurate, but perhaps more adaptive, approach to processing social information. These findings were robust after controlling for current level of depression and anxiety symptoms, intensity of response to the mood induction, response times, and performance on a control task.